Active NPI
Steven Gale Yuly, MPT
- Physical Therapist
- Eagle, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 1607
- Practice address
- 457 S Fitness PL
Suite 100
Eagle, ID 83616-6568 - Phone
- (208) 939-3332
- Fax
- (208) 939-3338
- NPI assigned
- Oct 5, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 1607 | ID | Primary |
Addresses
Primary practice location
457 S Fitness PL
Suite 100
Eagle, ID 83616-6568
Mailing address
2311 E Comisky St
Meridian, ID 83642-5301
Phone (208) 939-3332
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8071990000 | Medicaid | ID | |
| 000010142240 | Other | BLUE SHIELD | |
| TC530 | Other | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2204 E Lanark St
Suite 100
Meridian, ID 83642-5916
Phone (208) 908-7907
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 1607 | ID | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RS Physical Therapy PC | Physical Therapist | Current | Accepting new patients |
Locations
457 S Fitness Pl
Ste 100
Eagle, ID 83616
Phone (208) 939-3332
2204 E Lanark St
Ste 100
Meridian, ID 83642
Phone (208) 908-7907
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Eagle, ID
- NPI 1750478327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679669436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2311 E COMISKY ST",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836425301",
"telephone_number": "208-939-3332",
"fax_number": "208-939-3338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "457 S FITNESS PL",
"address_2": "SUITE 100",
"city": "EAGLE",
"state": "ID",
"postal_code": "836166568",
"telephone_number": "208-939-3332",
"fax_number": "208-939-3338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YULY",
"first_name": "STEVEN",
"middle_name": "GALE",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT 1607",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8071990000",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000010142240",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "TC530",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Eagle, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.